THE ROLE OF GLUTAMINE IN PRESERVING INTESTINAL BARRIER FUNCTION IN PEDIATRIC CONGENITAL HEART DISEASE
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Abstract
Background: Congenital heart disease (CHD) in pediatric patients is increasingly recognized not only as a structural cardiac condition but also as a systemic disorder associated with intestinal dysbiosis, barrier dysfunction, and heightened susceptibility to postoperative complications. Glutamine, a conditionally essential amino acid, plays a key role in preserving intestinal epithelial integrity and modulating immune responses.
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1.Abbasi F, Haghighat Lari MM, Khosravi GR, Mansouri E, Payandeh N, Milajerdi A. A systematic review and meta-analysis of clinical trials on the effects of glutamine supplementation on gut permeability in adults. Clin Nutr ESPEN. 2024;56:78–86. https://doi.org/10.1016/j.clnesp.2023.12.006
2.Huang Y, Lu W, Zeng M, Hu X, Su Z, Liu Y, et al. Mapping the early life gut microbiome in neonates with critical congenital heart disease: multiomics insights and implications for host metabolic and immunological health. Microbiome. 2022;10(1):121. https://doi.org/10.1186/s40168-022-01308-4
3.O’Sullivan A, O’Halloran KD, McDonnell B, et al. Protocol for a prospective cohort study exploring the gut microbiota of infants with congenital heart disease undergoing cardiopulmonary bypass (the GuMiBear study). BMJ Open. 2021;11:e048219. https://doi.org/10.1136/bmjopen-2020-048219
4.Tao KM, Li XQ, Yang LQ, Yu WF, Lu ZJ, Sun YM, et al. Glutamine supplementation for critically ill adults. Cochrane Database Syst Rev. 2022;2022(8):CD010050. https://doi.org/10.1002/14651858.CD010050.pub3
5.Rao R, Samak G. Role of Glutamine in Protection of Intestinal Epithelial Tight Junctions. J Nutr Metab. 2012;2012:867176. https://doi.org/10.1155/2012/867176
6.Pathan N, Hemingway CA, Alizadeh AA, et al. Role of intestinal epithelial barrier dysfunction in endotoxemia in children with congenital heart disease undergoing surgery. J Pediatr Surg. 2012;47(7):1250–1256. https://doi.org/10.1016/j.jpedsurg.2011.11.035
7.Navaei AH, Shekerdemian LS, Mohammad MA, et al. Derangement of Arginine and Related Amino Acids in Children Undergoing Surgery for Congenital Heart Disease With Cardiopulmonary Bypass. Crit Care Med. 2023;51(5):720–728. https://doi.org/10.1097/CCM.0000000000005791
8.MartinezGuryn K, Gordon JI. Human Intestinal Barrier: Effects of Stressors, Diet, Prebiotics, and Probiotics. Clin Transl Gastroenterol. 2021;12: e00308. https://doi.org/10.14309/ctg.0000000000000308
9.Frontiers Microbiology. Oxygenation and intestinal perfusion and its association with perturbations of the early life gut microbiota composition of children with congenital heart disease. Front Microbiol. 2024;15:1468842. https://doi.org/10.3389/fmicb.2024.1468842
10.Prykhodko O, Roberts C, Siwanowicz M, et al. The effect of glutamineenriched enteral nutrition on intestinal permeability in verylowbirthweight infants: a randomized controlled trial. J Pediatr Gastroenterol Nutr. 2007;45(6):648–654.
11.Butterworth M, Kurukulaaratchy R, Fearms K, et al. Intestinal barrier function and weight gain in malnourished children taking glutamine-enriched enteral formula. J Pediatr Gastroenterol Nutr. 2005;40(2):127–134.
12.Zhou Q, Verne ML, Fields JZ, et al. A randomized placebo-controlled trial of dietary glutamine supplements for postinfectious irritable bowel syndrome. Gut. 2018;68(6):996–1002. https://doi.org/10.1136/gutjnl-2017-315136
13.Ogden HB, Fallowfield J, Child RB, et al. No protective benefits of lowdose Lglutamine supplementation on intestinal permeability following heat stress: a randomized crossover trial. Temperature (Austin). 2022;9(2):196–210. https://doi.org/10.1080/23328940.2021.2015227
14.Goto M, Nishida Y, Shibata N, et al. Effect of oral glutamine supplementation on gut permeability and endotoxemia in patients with severe acute pancreatitis: a randomized controlled trial. Aliment Pharmacol Ther. 2014;39(12):1367–1374. https://doi.org/10.1111/apt.12766
15.Fardy M, Arts MT, Khan N, et al. Glutamine supplementation in sick children: is it beneficial? J Pediatr Gastroenterol Nutr. 2011;52(3):309–315. https://doi.org/10.1097/MPG.0b013e318219fe6d
16.Wischmeyer PE, Mahajan C, Levi J, et al. Intervention and mechanisms of alanyl-glutamine for inflammation, nutrition, and enteropathy: a randomized controlled trial in children. J Pediatr. 2023;187:60–68. https://doi.org/10.1016/j.jpeds.2023.04.032
17.Benjamin J, Ahuja V, Makharia GK, et al. Glutamine and whey protein improve intestinal permeability and morphology in patients with Crohn’s disease: a randomized controlled trial. Dig Dis Sci. 2012;57(4):1000–1007. https://doi.org/10.1007/s10620-011-1947-9
18.Beutheu S, Ouelaa W, Guérin C, et al. Glutamine supplementation improves gut barrier function during chemotherapy-induced mucositis in rats. Clin Nutr. 2014;33(4):694–701. https://doi.org/10.1016/j.clnu.2013.09.022
19.Noth R, Häsler R, Stüber E, et al. Oral glutamine supplementation improves intestinal permeability dysfunction in a murine acute graftvshost disease model. Am J Physiol Gastrointest Liver Physiol. 2013;304:G646–654. https://doi.org/10.1152/ajpgi.00176.2012
20.Sido B, Seel C, Hochlehnert A, Breitkreutz R, Droge W. Low intestinal glutamine level and low glutaminase activity in Crohn’s disease: a rationale for glutamine supplementation? Dig Dis Sci. 2006;51(12):2170–2177. https://doi.org/10.1007/s10620-006-9473-x